The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

Midwife / Client Relationships

See also:

• Midwifery Advocacy and Statistics

Subsections on this page:

• Resources
• Midwives as Naturally Empathic and Empathetic
• Bond Between Midwife and Client

Resources

The importance of reciprocity in relationships between community-based midwives and mothers.
Hunter B.
Midwifery. 2006 Apr 5; [Epub ahead of print]

Midwives as Naturally Empathic and Empathetic

This interesting research shows that there are specific genes related to oxytocin production and empathy.  They employ a specific test called "Reading the mind in the eyes" test, assessing the ability to guess what the other person is feeling.  These people are said to be extra empathic.  I would bet that most midwives have this gene, as this ability is incredibly helpful in working with nonverbal women during labor and birth.

Oxytocin receptor genetic variation relates to empathy and stress reactivity in humans. [full text]
Rodrigues SM, Saslow LR, Garcia N, John OP, Keltner D.
Proc Natl Acad Sci U S A. 2009 Dec 15;106(50):21437-41. Epub 2009 Nov 23.
Institute of Personality and Social Research, University of California, Berkeley, CA 94720, USA. sarina.rodrigues@oregonstate.edu

Oxytocin, a peptide that functions as both a hormone and neurotransmitter, has broad influences on social and emotional processing throughout the body and the brain. In this study, we tested how a polymorphism (rs53576) of the oxytocin receptor relates to two key social processes related to oxytocin: empathy and stress reactivity. Compared with individuals homozygous for the G allele of rs53576 (GG), individuals with one or two copies of the A allele (AG/AA) exhibited lower behavioral and dispositional empathy, as measured by the "Reading the Mind in the Eyes" Test and an other-oriented empathy scale. Furthermore, AA/AG individuals displayed higher physiological and dispositional stress reactivity than GG individuals, as determined by heart rate response during a startle anticipation task and an affective reactivity scale. Our results provide evidence of how a naturally occurring genetic variation of the oxytocin receptor relates to both empathy and stress profiles.
 

Scientists identify gene that influences quality of person’s empathy [November 17, 2009]
Mark Henderson, Science Editor

A gene that influences both the empathy people show towards others and their own responses to stress has been identified, in research that could shed new light on human psychology and disorders such as autism.

Scientists in the United States have discovered that people who inherit a particular version of a gene called the oxytocin receptor score significantly better on an empathy test, while reacting less strongly to stressful stimuli.

The findings, from a team led by Sarina Rodrigues, assistant professor with Oregon State University, and Laura Saslow, of the University of California, Berkeley, suggest a mechanism by which individuals’ genetic profiles may affect how well they recognise and respond to others’ emotions.

Bond Between Midwife and Client

We all talk about bonding with our baby, but what about the bond which also happens between a pregnant woman and her midwife?  After the birth of Harry and the 10 day checks I was really, really sorry to see my midwife leave my life.  She had become a good friend to me and saw me through one of the most intimate phases of my life.  I was lucky that the main midwife I saw during my pregnancy also insisted on staying with me for the birth of my son.

When the baby is born, everyone in the room is under the influence of the mother and baby's very strong baby hormones (endorphins).  As a midwife, I feel that it's not my place to intrude on that circle, that any bonding energy focused on me detracts from the family's bonding, but sometimes the birthing women try to draw me in.  Do women feel that they want the midwife to be part of that bonding circle, even though her time with the family is necessarily limited?  Does this seem to increase the feelings of loss and abandonment when you no longer have those regular visits with her?

Knowing that the relationship would eventually end I would prefer her to fade into the background, but not too much.   After all we did spend 9 months together.   We included our midwife and attendants in everything we did.  When it came time to say good-bye I was sad and wished our relationship could continue.  I still think about her and wish I could see her.    In reality she can not possibly bond with everyone she attends. Nor would it be fair to her to expect her too.

From a midwife point of view, I'm acutely aware that a birthing woman is just gushing with bonding hormones after the birth.  It's my feeling that these bonding hormones are best used to help her bond with her baby, her partner, and whoever else is going to be around to help with this baby for another 18 years.

I try very hard not to insinuate myself inappropriately in that first hour or so after birth.  I know some midwives who take advantage of this time to build "loyalty" in their clientele.  They may not be conscious of it, but I know they make a point of being part of the "family circle" after the birth.  I think it's inappropriate, and I think it increases the woman's feelings of abandonment when the midwife moves on to helping the next client, as she must.

Now, having said that, I really like most of my clients on a personal level, and yes, I miss them.  I think of all my clients almost all the time.  Every time I drive through someone's neighborhood, I'll think of driving there on the night of the birth.  I'll be reminded of clients by the silliest things.  And, yes, this is one of the sweetest parts of being a midwife - feeling that connection to all those wonderful families in the community.

Just today, I found myself driving behind a mini-van with a bumper sticker, "Support Your Local Midwife".  I wanted to stop them to see whether it might be one of my clients.

I guess it's a little like the way parents must feel when their children grow up and leave home.  You feel proud that you did a good job of seeing them through this rite of passage, and you also know that a huge part of that job was getting them to a point where they feel enough confidence to move on to the next step.